Wang Shih-Wen, Tseng Sung-Huei
Department of Ophthalmology, National Cheng-Kung University Hospital, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
Taiwan J Ophthalmol. 2015 Jul-Sep;5(3):136-139. doi: 10.1016/j.tjo.2015.04.001. Epub 2015 Jun 6.
We herein report two cases of occult Descemet's membrane detachment (DMD) after phacoemulsification surgery, which initially presented as persistent corneal edema and had been considered as pseudophakic bullous keratopathy. The patients were thus scheduled to receive corneal transplantation. For Case 1, DMD was incidentally detected by slit-lamp examination 2 months postoperatively, only when part of the cornea became clearer. For Case 2, anterior segment optical coherence tomography demonstrated extensive DMD, which had lasted 5 months after the operation. DMDs in both patients had been successfully attached after descemetopexy. Occult DMD should be suspected in patients with persistent severe corneal edema after phacoemulsification surgery. Corneal transplantation may be avoided by timely diagnosis and treatment of DMD.
我们在此报告两例白内障超声乳化手术后隐匿性后弹力层脱离（DMD）的病例，最初表现为持续性角膜水肿，曾被认为是人工晶状体性大泡性角膜病变。因此，这两名患者被安排接受角膜移植。病例1术后2个月，仅当角膜部分区域变清晰时，裂隙灯检查偶然发现了DMD。病例2，眼前节光学相干断层扫描显示广泛的DMD，术后已持续5个月。两名患者的DMD在施行后弹力层固定术后均成功复位。白内障超声乳化手术后出现持续性严重角膜水肿的患者应怀疑隐匿性DMD。及时诊断和治疗DMD可避免角膜移植。
